Older women suffering from urine incontinence can benefit from frequent, low-impact exercise, including yoga, stretching, and strengthening, according to a new study.
The research, led by scientists at Stanford Medicine and the University of California, San Francisco, is part of a bigger attempt to develop low-risk, low-cost treatments for one of the most frequent health concerns that women encounter as they age.
After 12 weeks of a low-impact yoga exercise, study participants experienced approximately 65 per cent fewer incontinence episodes. Women in a control group who did stretching and strengthening activities saw similar results over the same period. According to the researchers, the benefits are comparable to the effects of incontinence medications.
"Our study was testing the kind of yoga that just about anyone can do, with modifications for different physical abilities," said the study's senior author, Leslee Subak, MD, chair of obstetrics and gynaecology at Stanford Medicine. "What I love about it is that it's safe, inexpensive, doesn't require a doctor and is accessible wherever you live." Because the trial was conducted partly during the Covid-19 pandemic, many participants received their yoga or exercise instruction via online meetings, exercising in their own homes, she noted.
The study's lead author is Alison Huang, MD, professor of medicine, urology, and epidemiology and biostatistics at UCSF.
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Urinary incontinence, which affects more than half of middle-aged women and up to 80 per cent of 80-year-olds, can lead to a variety of other problems, from social isolation to bone fractures caused by falls. But there is help.
"Part of the problem is that incontinence is stigmatised; we don't talk about it," said Subak, the Katharine Dexter McCormick and Stanley McCormick Memorial Professor III. "Or we hear folklore about this being normal when you get older. In fact, it's very common but it's not inevitable, and we have very effective ways of treating it." Incontinence deserves good treatment because of the many ways it interferes with people's lives.
"It takes away independence," Subak said. "My patients will say, 'I can't stay with my kids or grandkids because I'm afraid I'll wet the bed, and I can't talk about it; it's too embarrassing'."
Patients may avoid activities that could boost their wellness, such as exercising and seeing friends. They are more likely to be admitted to a nursing home and to suffer certain serious medical problems such as hip fractures.
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"Incontinence and overactive bladder are among the biggest risk factors for falls and fractures among older women," Subak said. "You're rushing to the bathroom at night – with the lights off – tripping and falling, and breaking a hip."
Some factors that contribute to risk for incontinence can't be changed, such as aging or having had children. But others are modifiable.
"A lot of my research has focused on weight loss and physical activity, which in fact are effective treatments," Subak said. She became interested in studying yoga as a treatment after some of her patients told her it helped them.
The study compared two 12-week exercise programs: 121 participants were randomly assigned to yoga, and 119 to a physical conditioning control group. The participants were women with urinary incontinence that caused symptoms at least once a day. They were 45 to 90 years old, with a mean age of 62.
In the yoga program, participants learned 16 hatha yoga poses intended to strengthen the pelvic floor, via two 90-minute sessions per week. The pelvic floor consists of the muscles that form the base of the pelvis and hold its organs – including the bladder and urethra -- in place. Participants were also asked to practice yoga for at least one hour per week outside of class and to maintain a practice log.
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Participants in the control group spent an equal amount of time in exercise classes, but their classes focused on nonspecific stretching and strengthening exercises that did not engage the pelvic floor. They were also asked to practice for an additional hour per week and keep a practice log.
The study began with in-person classes, then transitioned to a videoconference format when the Covid-19 pandemic lockdowns began.
(ANI)